School Site Response to Intervention (RTI) Information Survey

Survey to determine the knowledge and needs of RTI within the district.
Name: 


A red asterisk (*) indicates required questions.

  1. Rate your school staff on the knowledge of the general concepts of RTI.*
    Basic knowledge of this model
    Developing an awareness of this model
    Fully knowledgeable in this model


  1. The majority of the staff (80% or more) appears ready to give the RTI model a try, believing that it benefits teachers and students.*
    Yes
    No


  1. Which tiers of RTI are being implemented at your site? Choose all that apply.*
    Tier 1 contains programs available to all students, such as universal screening.
    Tier 2 addresses the needs of students who show emerging deficits and includes individualized intervention plans designed by the School Invention Team.
    Tier 3 is the most intensive level of individual assistance available in the school (not counting special education).


  1. What types of universal screening(s) for academic skills are being used at your site? (i.e., DIBELS, Curriculum-Based Materials, teacher created pre- and post-tests). List all that apply.*


  1. What types of universal screening(s) for behaviors are being used at your site? List all that apply.*


  1. Does your school have a Student Intervention Team (SIT) or PLC, which provides interventions for struggling students? If yes, who is responsible for providing these interventions?*


  1. Does your school have a Student Intervention Team (SIT) in place? Describe the type of data that is collected and presented to the team on a referred student.*


  1. Staff use progress monitoring data to inform instruction.*
    Yes
    No


  1. Staff other than teachers delivers student interventions at my school.*
    Yes
    No


  1. At what stage is your school in RTI implementation?*
    Investigation
    Planning
    Piloting in a limited number of grade levels
    Effective working model schoolwide


  1. For which grades have you implemented RTI? Choose all that apply.*
    Kindergarten
    1st
    2nd
    3rd
    4th
    5ht
    6th
    7th
    8th
    9th
    10th
    11th
    12th
    We have not implemented RTI at my site


  1. For which subject areas have you implemented RTI? Choose all that apply.*
    Reading
    Math
    Behavior
    Writing
    Language
    Other
    None


  1. What type of assistance do you need in order to begin implementing or continue implementing an RTI model? *





Ray Smith